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Home My WebLink About8554-zFOI~I NO. 4 TOWN OF $OUTHOLD BUILDING DEPARTMENT Town Clerk's Office Southold, N. Y. Certificate O[ Occupancy Map No. Bayylew. Pk Block No ........... Lot No, Pt..t,2,~t~,& .9,10.rll.. Mattituek conforms substantially to the Application for Building Permit heretofore filed in this office dated ........... Apr:~l, .30, 19.~.6. pursuant to which Building Permit No...~.~Z. dated .......... Ap.~.$.i...3.~.., 19.~.6., was issued, and conforms to ail of the require- ments of the applicable provisions of the law. The occupancy for which this certificate is issued is ...P~..J-.V,a.~9..ORe.. g.a.~.! .lY..d. W9.1.~.~.~.~...(~e. Pk&.e.e..mgD.~.). .................... The certificate is issued to D~'..A~b.~2t. H~oad .&..G. oo ~al~l~olld...~el*.s ......... (owner, lessee or tenant) of the aforesaid building. Suffolk County Department of Health Approval .$;~$~;~.r~g. systems. ................ UNDERWRITERS CERTIFICATE No.. ]~9~Z~[~... A~.. ~..~97g ................ HOUSE NUMBER . ] ?~0 ........ Street ....~l,~.~'. ~0. ~W.,. ....................... FOBM NO. ~ TOWN OF SOUTHOLD BUILDING DEPARTMENT TOWN CLERK'S OFFICE SOUTHOLD, N.. Y. BUILDING PERMIT (THIS PERMIT MUST BE KEPT ON THE PP, EMISES UNTIL FULL COMPLETION OF THE WORK AUTHORIZED) N? 855 Z Permission is hereby granted to: ¥~uad~a~..~-.~.~. c~ng.. A/.C.. A~bex f~ ..&..~ e.o tta~mond .................... ~oethet~..... ................................... ~o .b~il~..~e~..aue...f~ 1;~...d~ell/mg...../,..~e~l~cXng..bumrzed...o~t..tlwalllng~... at premises located at ...~.~]?.t~.~1.e2~3~.~..C..~t~..~t2~9.e~1.~e.~..~c`..~..~.~1c~; ..... ....................................... I~l,l~e r...P,, 0.,;n~..or... ~ o~t ~, ..I).~ .............. b~a.t,t a.tuei~.....l~.,~., .......... pursuant to opplJcatJon dated ............... ~,~.~'[......3t3 .................., 19~.~.6.., arid opproved by the Building Inspector. Fee $..?.. ~.,..kk-D. .......... ........ .................. I ' Building [Rspector THE NEW YORK BOARD ~OF FIRE UNDERWRITERS ,, BUREAU OF ELECTRICITY ~Tt'[" 85 JOHN STREET, NEW YORK, NEW YORK 10038 ~,.,e ^UgUSt 6. 1976 ~,,,,,~a,io. No.o..S, le 859521' N 297258 THIS CERTIFIES THAT ' ' only tb~e electrical equiprnen£ as described below and introduced by the applicant named oB the above applwat~o~ number ~ the premises of ,, George Ht~raraond, 1750 HillerRd., Hottil;uck, L.I. in thefoltowinglocation; ~ B~emen~ ~ 1st FL ~ 2nd FL outside, ~ s~io. m~ Lo~ ~.,~do. August "4, 1976 'a~f°undtqheinc°mplla~qe~it'~therequirements°fthi~B°ard' DRYERS )THER APPARATUS: 5/o NO, OF N~UTRALS A W G ~ 5/0 1 GFCI Robert Goodale RR1 Box 1SA }~ain Rd. ~attituck, L.I. 11952 Lic. 785 n ~ This certificate must not be altered in any manner; return to the office of the Board if incorrect. Inspectors ~y their'~dentials. TOWN OF SOUTNOLD'=~ BUILDING DEPARTMENT -~ TOWN CLERK'S OFFICE '/'/~'-- ~ ~-'~.~ ; ~UTH~D, N.Y. ~ ...... .............. . ........ ............... ............ :'. ......... .......... . ...... INSTRUCTIONS a. This application must be completely filled in by typewriter or in ink and submitted in triplicate to the Building Inspector, with 3 sets of plans, accurate plot plan to scale. Fee according to schedule. b. Plot plan showing location of lot and of buildings on premises, relationship to adjoining premises or public streets of areas, and giving a detailed description of layout ofproperty must be drawn on the diagram which is part of this application. c. The work covered by this application may not be commenced before issuance of Building Permit. d. Upon approval of this application, the Building Inspector will issue a Building Permit to the applicant. Such permit shall be kept on the premises available for inspection throughout the work. e. No building shall be OCCupied or used in whole or in part for any purpose whatever until a Certificate of Occupancy shall have been granted by the Building Inspector. APPLICATION IS HEREBY /Vu~DE to the Building Department for the issuance of a Building Permit pursuant to the Building Zone Ordinance of the Town of Southold, Suffolk County, New York, and other applicable Laws, Ordinances or Regulations, for the construction of buildings, additions or alterations, or for removal or demolition, as herein describedf-~x The applicant agrees to comply with all applicable laws, ordinances, building code, housing code, and regulations, end tcj admit authorized inspectors on premises and in buildings for necessary inspections. ............. ~..~.~.i.~ ........................ .U.i..!.~ .................. (Signature of applicant, or name, if a ~:°rporatic~n) · (Address of applicant) .............. State whether applicant is owner, lessee, agent, architect, engineer, general contractor, electrician, plumber or builder. ................................................. ~.~..~.~...L..'~... ................................................................................................... Name of owner of premises ....~,~;~..~.b~..~.~..~......~.¢...~..~.....~..:...~.....~.....~...~..1~...~...~...'''''''''''''' If applicant is a corporate, signature pr/duly authoriD~r, oJ;[icer. (Name and title of corporate officer) Builder's License No ..................................................... Plumber's License No .... /.~...~....~....~r..~.~..~.~[~'/~'~'~t, Electrician's License No. Other Trade's License No ............................................... Locat on of and on wh ch proposed work will be done Map No' ' .... Street and Numbe ...~,,.h.~X&....~m~r...o...~....~..~., ......... : ............ ~,~ ........... ~.. t~ , ~ ~ ~ n* ' ' State existing use and ~cupancy of premises and in~ended use and ~cupancy of pr~osed construction: a. Exisiting use a~ ~cupancy ....... ~.~...~.t.~.~ .............................................. b. Intended and use 3. Nature of work (check which applicable): New Building .................. Addition .................. Alteration ................ Repair .................. Removal .................. Demolitior ..................... Other Work ................................................ .... ~i~ ? O~ (Description) 4. Estimated Cost ...... ~.~....'~.;).C~. ..................................... Fee ~.-..~-.. (to be paid on filing this application) 5. If dwelling, number of dwelling units ......... ~...~.~... ...... Number of dwelling units on each floor ............................ If garage, number of cars .................... LI~J.O.~.~ ........................................................................ ; ................... ; ........ 6. If business, commercial or mixed occupancy, specify nature and extent of each type of use ........... ~ ................ 7. Dimensions of existing structures, if any: Front ............................ Rear ................................ Depth .................... Height ........................ Number of Stories ................................................................................................................. Dimensions of same structure with alterations or additions: Front ....................................Rear ............................ Depth ................................ Height ............................ Number of Stories ................................ 8. Dimensions of entire new construction: Front ....... .~...~ ...................... Rear ...... ..~....~..L ........... Depth .....~..~..~..~...t.). .... Height ~ ........ Number of Stories ..~...~. ............................................................................. ; .................... ........... . 9. Size of lot: Front ........... !..~...O........~...~. ....................... Rear .................. ~ ..................... Depth ...... ~ ...... :....1. ......... 10. Date of Purchase ..~ .................................... Name of Former Owner ....:: .................................................. 1 1. Zone or use district in which premises are situated ..................................................................................................... 12. Does proposed construction violate any zoning law, ordinance or regulation: ....... ~..13 .......................................... 13. Will lot be regraded . ........................... Will excess_fill be re,moved from premises: ( I~Yes ( ) No 14. Name of Owner of premises ..0..~.,.}.~...~....~.v.9.~:'~..~....(.~...~..?..~- ... Address ..~.~,1~'/~..~.I..~.. ...... Phone No ....................... Name of Architect ....: .......... ~ ............................................. Address 'l',l~o~O~ho Phone No. Name of Contractor .~.j.~.r~....~...~.~.l~..~.l.~..~,l.. ~(~.v/,;~-- -- ~ -- .... I'~,o ~.,./.~.~.....~..~ ............... ~)/~,-~1 ~'~~'' . Address Phone mo ...................... PLOT DIAGRAM Locate clearly and distinctly all buildings, whether existing or proposed, and indicate all set-beck dimensions from property lines. Give street and block number or description according to deed, and show street nomes and indicate whether interior or corner lot. STATE OF NE'v~/ Y^C~RK_.~ COUNTY OF .~.Lt..$~L'0..J=.~. ............... ............................. ~o~ez, J;..~,,...'~'e33f;]~'l'l .......................... being duly sworn, deposes and says that he is the applicam (Name of individual signing contracf) above named. He is the ....... .q.O..~...~.~.~,O.~...O.~ ..................................... i ......................................................................... ................................... (Contractor, agent, corporate officer, etc.) of said owner or owners, and is duly authorized to perform or have performed the said work and to make and file this application; that all statements contained in this application are true to the best of his knowledge and belief; and ti,ar the work will be performed in the manner set forth in the opplicatio~ filed therewith. Sworn to before me this ~ / ....... ,,~.C)~t~ ....... day of ............... ~1~.~,~ .............. ....,, Nota Pub,ic. . ......... ......... _~ ~ . ............. ~ ......... ,,~ ~ ~ ~ (Signature of applicant) ELIZABETH ANN N~VILL£ NOTARY PUBLI~. State of New York No. 52-8125850. SuffolkCou Term Expires March 30, ]9 NOTE · = MONUI~ENT LOT NUMBERS REFER TO MAP OF "DAY VIE~I PARK" FILED IN THE OFFICE OF THE CLERK OF SUFFOLK COUNTY OIV MAYID~ IDIO AS FILE NO 578 \96 16 TITLE NO 1252191 YOUNG & YOUNG 400 OSTRANDER AVENUE, RIV£RHEAD, FlEW YORK SURVEY FOR: GEORGE K. HAMMOND AT ATT T I GLIARANTEEE) 'TO: _ MATTITUCK J THE TITLE GU~/~ANTEE CO ~owuo~ SOUTHOLD , ~ SUFFOLK CO., N.Y. /'x ~ ~ ~ ~/T R H.^M ONb AppROVED AS ~O.'[E~D 765-2660 9AM TO 4,p~ FU~, _ ,i~ INSPECTIONS: F' OU. NI b..A :Ti_ 0 N .t P LA N E L 'El V'~,'I ON